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Mirtazapine (Atypical Antidepressant)

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Mirtazapine

What is Mirtazapine?

Mirtazapine is an antidepressant. It is primarily used to treat depression. Depression, or major depressive disorder, is a mental health condition whereby a person may feel sad, unhappy or upset for extended periods of time, often for no explainable reason. Mirtazapine can help alleviate these symptoms.

Mirtazapine can also be used to help you sleep if you experience major depression, and it is causing you to suffer from insomnia.

Mirtazapine is generally prescribed when other antidepressants haven’t worked. It’s only available if you have a valid prescription from a GP. Alternatively, we can prescribe it to you online following a brief assessment. To find out more about this, contact us. Mirtazapine is available as a generic drug, and also under the brand name Remeron. Other brands are available.

For more information about Mirtazapine, you can consult the patient information leaflet.

How it works

Mirtazapine, like other atypical antidepressant drugs, is thought to work by altering chemicals called neurotransmitters in the brain. Specifically it’s thought to affect serotonin and norepinephrine, which are responsible for mood and social behaviour. By altering these chemicals in the brain, it’s thought that the effects of depression are reduced.

Mirtazapine is usually quicker than other antidepressants to start working. It generally takes between one to two weeks to start working, however it can take up to six weeks to become fully effective. You may not feel any improvement to your symptoms within the first few weeks.

Before you take it

If you are epileptic, Mirtazapine may increase the frequency of your seizures. If this happens, you should stop taking this medication and consult your doctor.

Mirtazapine is not suitable for those with severe heart problems, such as heart disease or angina. Mirtazapine can decrease blood pressure, which can make certain heart problems worse. Speak to your doctor before you take Mirtazapine if this applies to you.

Mirtazapine is also not suitable for those who have kidney problems or renal impairment. This is because your kidneys may not work well enough to clear Mirtazapine from your body. If you are concerned about this, talk to your doctor before you take Mirtazapine.

Mirtazapine may increase the pressure in your eye, or cause dilated pupils. If you have an eye condition called glaucoma, Mirtazapine may be unsuitable for you, and you should consult your doctor to discuss alternative treatment.

Mirtazapine can have the unwanted side effect or making your depression worse, or causing suicidal thoughts or thoughts of harming yourself. If this happens you must immediately speak with your doctor. Mirtazapine can also trigger a manic episode if you suffer from bipolar disorder or mania.

If you are pregnant or planning to become pregnant, you should consult your doctor before using Mirtazapine. This is because it is unknown how Mirtazapine affects a developing baby, so may be unsuitable for you during pregnancy. Your doctor will decide whether the benefits of taking Mirtazapine during pregnancy outweigh the risks.

Mirtazapine can trigger changes in your mood or behaviour. If this happens, you must consult your doctor. Mirtazapine may be unsuitable for you. Mirtazapine may also cause withdrawal symptoms, so do not stop taking it unless your doctor tells you to.

If you drink alcohol while taking Mirtazapine, it may increase your risk of side effects. It can also make side effects that you are already experiencing worse. You are advised not to drink alcohol when taking Mirtazapine.

Mirtazapine may interact with some other medications. It is very important that you speak to your doctor before taking Mirtazapine if any of the following apply to you:

  • You’re taking anti-anxiety drugs such as diazepam, triazolam and midazolam
  • You’re taking any SSRI, SNRI, Lithium or any other medication for depression, as taking these with Mirtazapine can cause serotonin syndrome
  • You’re taking warfarin, aspirin or any other medication used to thin the blood
  • You’re taking any drug that may increase or decrease the amount of Mirtazapine in your body
  • You’re taking fentanyl or tramadol
  • You’re taking ritonavir or any other HIV medication

This is not a full list of medication that may cause drug interactions with Mirtazapine. For a complete list, please refer to the patient information leaflet.

Dosage Instructions

You should take Mirtazapine only as prescribed. Do not exceed the stated dose. If you are unsure as to how much to take, speak to your doctor or pharmacist first.

The recommended daily starting dose is 15 mg to 30 mg per day. Your doctor may adjust this depending on your body’s reaction to the medication. Keep in mind that if you are elderly, or have renal or liver impairment, your dosage will be lower.

You should generally take Mirtazapine tablets once per day, before you go to sleep. However, your doctor may advise you otherwise. Always follow your doctor’s instructions.

Swallow your tablets whole, with plenty of water. Do not chew, crush or suck on them. You can take Mirtazapine with or without food.

Store Mirtazapine at room temperature, out of the reach of children and pets.

Common Side Effects of Mirtazapine

Mirtazapine, like most medications, may cause side effects. These are usually mild to moderate in nature, and will usually go away on their own as your body becomes used to the medication. However, if they persist, or they concern you, you should consult your doctor or pharmacist for advice.

  • Increased appetite
  • Weight gain
  • Dry mouth
  • Headaches
  • Rash
  • Nightmares (Mirtazapine can increase the time you spend in REM sleep)
  • Muscle or joint pain
  • Insomnia
  • Vomiting
  • Diarrhoea
  • Nausea

Mirtazapine also has the potential to cause more serious side effects. These are rare, but if you do experience them you should consult your pharmacist or doctor right away. They include:

  • Fainting
  • Low blood pressure
  • Hallucinations
  • Drowsiness
  • Restlessness
  • Abnormal sensation in the mouth
  • Swelling throughout the body
  • Muscle pain or weakness

Mirtazapine can also cause a serious allergic reaction in some patients. This is very rare, but an allergic reaction is an emergency, and if you believe you are having an allergic reaction to Mirtazapine, you must immediately seek medical advice. Symptoms can include:

  • Skin rash, including redness, bleeding, blistering, peeling
  • Hives, nettle rash
  • Trouble breathing or speaking
  • Wheezing
  • Swelling of the tongue, mouth, nose, throat or face

This is not an exhaustive list of side effects. A full list is contained within the patient information leaflet.



Frequently Asked Questions (FAQs)


Is Mirtazapine suitable for children?

No. Mirtazapine should only be taken by over 18s and is not suitable for use in children and adolescents. Additionally, we do not prescribe medication to anyone under the age of 18.

I’m pregnant. Can I take Mirtazapine?

Mirtazapine should not generally be used during pregnancy unless your doctor advises you to. They will only do this if they feel the benefits of taking Mirtazapine during pregnancy outweigh the risks.

What happens if I miss a dose?

If you miss your usual dose of Mirtazapine, skip the missed dose and take your next dose as scheduled. Never take more than one dose at once, and never double up to make up for a missed dose.

What happens if I take too much?

If you believe you have overdosed on Mirtazapine, you should immediately go to your local hospital or casualty centre. An overdose of Mirtazapine can cause numerous unwanted side effects, including increased heart rate, dizziness and disorientation. If you show symptoms such as fainting, arrhythmia, these can potentially indicate a life-threatening condition called Torsade de Pointes, which can be brought on by a Mirtazapine overdose.

More Information
Dosage No
Dosage Instructions Take ONE as directed by your doctor.